guest ::
| Home > Publications database > Cost effectiveness analysis of prostate cancer screening strategies in Germany: A microsimulation study. |
| Home > Publications database > Cost effectiveness analysis of prostate cancer screening strategies in Germany: A microsimulation study. |
| Journal Article | DKFZ-2025-01469 |
; ; ; ; ; ; ; ; ; ;
2025
Wiley Interscience
New York, NY
This record in other databases: 
Please use a persistent id in citations: doi:10.1002/ijc.35513
Abstract: Prostate cancer (PCa) represents a significant public health challenge in Germany, with increasing incidence and economic impact. This study assessed the cost-effectiveness of 10 screening strategies: prostate-specific antigen-based risk-adaptive screening (PSA-RAS), with or without magnetic resonance imaging (MRI), in men starting at age 45 or 50 and stopping at 60 or 70, digital rectal examination (DRE) for ages 45-75 years, and no screening. Using a well calibrated microsimulation model (Swedish Prostata) from a statutory health insurance perspective, lifetime outcomes were evaluated, including cancer incidence, mortality, overdiagnosis, biopsies, life-years, and quality-adjusted life-years (QALYs) discounted annually at 3%. Cost and utility inputs were derived from the German diagnostic-related group schedule, fee-for-service catalogues, literature, and expert opinion. DRE-only was the least cost-effective, yielding high biopsy and overdiagnosis rates with minimal QALY gains. PSA-RAS reduced overdiagnosis and biopsy rates, with PSA-RAS (50-60 years) without MRI emerging as the most cost-efficient strategy, saving approximately €1.2 million per 100,000 men compared with no screening. Extending the PSA-RAS to 70 years improved its effectiveness in terms of QALYs. PSA-RAS (50-70) with MRI could become cost-effective at an increasing willingness to pay threshold or decreasing MRI cost. This study suggests the potential of PSA-RAS to improve PCa screening in Germany. Incorporating MRI, reducing MRI cost within the screening setting, and extending screening to 70 to align with EU recommendations could improve the cost-effectiveness of PSA-RAS with MRI. Future research should explore the integration of MRI with ancillary tests, such as 4K-score or risk calculators, to reduce MRI use and associated costs.
Keyword(s): QALYs ; cost‐effectiveness analysis ; magnetic resonance imaging ; organised screening ; prostate cancer ; prostate‐specific antigen
; Nationallizenz
; SCOPUS
|
The record appears in these collections: |
